Health Study Activities Frequently Asked Questions (FAQs)
Health Survey Information
1. Why are you doing the health survey?
On January 28, 2008, President Bush signed the 2008 National Defense Authorization Act. This required ATSDR to develop a health survey of persons possibly exposed to contaminated drinking water at Camp Lejeune.
2. Who was eligible for the survey?
Anyone who lived or worked at Camp Lejeune during the period of drinking water contamination was eligible for the survey. ATSDR couldn't identify all of these people from available records, so we sent the survey to the people we could identify.
People who received the survey included:
- former active duty marines and sailors who were stationed at Camp Lejeune anytime between April 1975 and December 1985
- civilian employees who worked at the base anytime between October 1972 nd December 1985
- People who took part in ATSDR’s 1999-2002 survey
- a sample of former active duty and civilian workers from Camp Pendleton
- people who requested a health survey by registering with the United States Marine Corps before June 30, 2011 (this effort is ongoing)
3. Why did you survey former active duty and civilian workers from Camp Pendleton?
Active duty and civilians who worked at Camp Pendleton and Camp Lejeune are similar except for their exposures to chemicals in drinking water. The information from those who lived at Camp Pendleton allows us to compare the health experiences between these two groups. This will help us determine if contaminated drinking water at Camp Lejeune affected people’s health.
4. What conditions did the health survey ask about?
The health survey asked questions about more than twenty different cancers and other diseases. People also had space to report other diseases not mentioned in the survey.
5. When was the survey sent?
The surveys were mailed in waves about every three weeks from June 2011 through December 2011.
6. Why didn’t I get a survey?
You may not have received a survey because you are not part of one of the groups included in the health survey. The following groups were included in the health survey:
- former active duty marines and sailors who were stationed at Camp Lejeune anytime during April 1975 and December 1985
- civilian employees who worked at the base anytime during October 1972 to December 1985
- people who took part in ATSDR’s 1999-2002 survey
- a sample of former active duty and civilian workers from Camp Pendleton
- people who requested a health survey by registering with the USMC by June 30, 2011
Even if you did not receive a survey, if you lived or worked at one of the bases during this time, the results will apply to you.
7. When will the survey results be available?
We expect to release the survey findings in 2014. Until then, we will be collecting, analyzing and scientifically verifying the results reported by participants.
ATSDR will make survey results available through a web broadcast. Survey participants will receive a summary of the final report. The findings of the survey also will be published in a peer-reviewed scientific journal.↑back to top
What other studies is ATSDR planning to conduct?
ATSDR began conducting a mortality study in April 2010. The study is looking at all causes of death, including cancers and other fatal diseases to determine if there is a link between the death and exposure to contaminated drinking water at Camp Lejeune. The study focuses on marines who started active duty on or after April 1975 and who were stationed at Camp Lejeune anytime between April 1975 and December 1985. The study also focuses on civilian employees who began work with the Department of Defense on or after April 1974 and who worked at Camp Lejeune anytime between April 1974 to December 1985.
The mortality study also includes an unexposed sample of former active duty and civilian workers from Camp Pendleton.↑back to top
Male Breast Cancer Study
1. Why is ATSDR doing a male breast cancer study?
ATSDR is conducting the male breast cancer study to address a concern expressed by members of the Camp Lejeune Community Assistance Panel (CAP) related to the number of cases of breast cancer in males who lived or worked on the base when the water was contaminated. This study aims to examine whether there is a relation between exposure to drinking water contaminated with volatile organic compounds (VOCs) at the U.S. Marine Corps Base, Camp Lejeune and male breast cancer.
Currently, the cause of male breast cancer is unknown, and there is limited scientific research on the relationship between the VOCs in the drinking water at Camp Lejeune and male breast cancer. Scientific support for the study comes from research conducted in Cape Cod, Massachusetts which suggests a relationship between exposure to VOC contaminated drinking water and female breast cancer (1, 2, 3).
2. Why does this study focus only on male breast cancer?
This study focuses on male breast cancer because there is very limited information on the cause of breast cancer among men. The lack of scientific information on the disease is in part due to the uncommon occurrence of the disease among men. For every 1,000 cases of breast cancer in the United States about 7 occur among men. ATSDR’s male breast cancer study aims to further the scientific understanding of the disease by investigating whether exposure to VOCs in the drinking water at Camp Lejeune is associated with developing this uncommon disease.
3. Who is included in the study?
Those included in the study will be selected from the Department of Veteran’s Affairs (VA) Central Cancer Registry. The VA’s cancer registry maintains information from eligible veterans who were diagnosed with cancer or were treated for cancer at a VA clinic. Eligible study members are male Marines born before January 1, 1969 and diagnosed with cancer or treated for cancer at a VA medical facility from January 1, 1995, (the start of the VA’s Central Cancer Registry) to the latest date that complete medical records are available.
4. How will the study be conducted?
The study will be conducted using a case-control design. This design is useful for investigating uncommon diseases such as male breast cancer. The study compares cases to controls looking for differences in exposure levels and the occurrence of disease. Cases are all eligible study members diagnosed with male breast cancer. Controls are randomly selected from the remaining eligible study members not diagnosed with male breast cancer. ATSDR will determine whether cases were more likely than controls to live in housing areas known to have higher levels of VOC in the drinking water supply.
5. What are some of the limitations of this study?
One limitation with this study, specific to the case-control study design, is reliance on historical data to determine exposure to VOC in the drinking water supply. The exact level of exposure is not available for each individual who resided or worked on the base during the period that VOC contamination was in the drinking water at Camp Lejeune, and the level of VOC contamination in the drinking water supply varied by location on the base.
To address this potential limitation, ATSDR estimated VOC contamination levels among the different housing areas on the base. The study will assign exposure levels to each case and control on the basis of residential location and the period of time the study participant was stationed on base. From this information, ATSDR will evaluate whether the contaminated drinking water at Camp Lejeune is related to male breast cancer.
6. Why does the study include only male Marines and not their dependents or civilian employees?
The study includes only male Marines and not their dependents or civilian employees because the VA’s cancer registry is not available for military dependents that lived at Camp Lejeune or civilian workers employed on the base. The VA cancer registry provides the most up to date and accurate information enabling us to conduct this study and facilitate the identification of Marines who served during the time when the water was contaminated. ATSDR is using 2011 health survey data to conduct other health studies that include breast cancer among females who were active duty military members or civilians who worked at Camp Lejeune during the time when the water was contaminated.
7. When will the study results be available?
ATSDR expects to submit the study findings for publication in 2015.
- Aschengrau, A., Paulu, C., & Ozonoff, D. (1998). Tetrachloroethylene-contaminated drinking water and the risk of breast cancer. Environmental health perspectives, 106(Suppl 4), 947.
- Aschengrau, A., Rogers, S., & Ozonoff, D. (2003). Perchloroethylene-contaminated drinking water and the risk of breast cancer: additional results from Cape Cod, Massachusetts, USA. Environmental health perspectives, 111(2), 167.
- Ozonoff, A., Webster, T., Vieira, V., Weinberg, J., Ozonoff, D., & Aschengrau, A. (2005). Cluster detection methods applied to the Upper Cape Cod cancer data. Environmental Health, 4(1), 19.
1997 Public Health Assessment (PHA)
1. Why did the 1997 PHA not mention benzene was present in well 602?
The 1997 PHA does mention benzene in Appendix B (page B-2-4). It does not mention or discuss benzene in the main body of the PHA because we assumed, incorrectly at the time, that well # 602 was not used to supply contaminated drinking water to residents of Camp Lejeune.
2. Why did ATSDR remove the 1997 PHA from the ATSDR Camp Lejeune website?
In the time since the 1997 PHA was published, additional information emerged related to exposures to volatile organic compounds in drinking water at Camp Lejeune. Due in part to ATSDR’s ongoing extensive water modeling and exposure reconstruction study, we learned that communities serviced by the Holcomb Boulevard distribution system were exposed to contaminated water for a longer period than we knew in 1997. Also, at the Camp Lejeune site, benzene was present in one drinking-water supply well in the Hadnot Point drinking water system. That well was shut down sometime prior to 1985. This information should have been included in the PHA but was not. The PHA should have mentioned the contamination and stated that the extent of exposure to benzene from that well was unknown.
3. When will the revised PHA be available?
ATSDR plans to revise the PHA once the water modeling study is complete. Water modeling is a scientifically complex. In the meantime, we continue to stand behind the information related to the other nine pathways.↑back to top